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Pathophysiology > Adrenal Gland > Flashcards

Flashcards in Adrenal Gland Deck (35):
1

adrenal glands are made up of

adrenal cortex
adrenal medulla
(two separate glands)

2

what does the adrenal gland respond to

stress
-infection
-heat/cold
-dehydration
-exercise

3

adrenal cortex secretes

mineralocorticoids
glucocorticoids
sex steroids

4

adrenal medulla secretes

epinephrine
norepinephrine

5

mineralocorticoids

fluid and ion balance
-promote retention of sodium and loss of potassium

6

glucocorticoids

play role in overall response to stress
-preserve carbohydrates
-mobilize amino acid
-promote gluconeogenesis
-anti-inflammatory

7

sex steroids secreted by adrenal cortex

androgens
estrogens
progestins

8

epinephrine

promotes glycolysis
stimulates release of ACTH
effects heart and vasculature

9

norepinephrine

acts upon heart and vasculature

10

pheochromocytoma

tumor that affects adrenal medulla
results in increased production and release of catecholamines

11

sx of pheochromocytoma

excessive BP
tachycardia
headache
inappropriate sweating
GI disorders

12

hypofunction of adrenal cortex

"adrenal insufficiency"
decrease in hormones produced
primary (problem is in adrenal cortex) and secondary (problem is elsewhere; pituitary) types

13

hyperfunction of adrenal cortex

increase in hormones produced

14

primary adrenal insufficiency AKA

Addison's Disease

15

incidence of Addison's Disease

affects both genders equally over lifespan
rare

16

why was Addison's Disease more common in the past

tuberculosis

17

what typically causes Addison's Disease

autoimmune disease
more than 1/2 of patients with Addison's Disease seem to have an autoimmune disorder

18

what are causes of Addison's Disease other than autoimmune

bilateral adrenalectomy
radiation to the adrenals
adrenal hemorrhage or infarct
infections (histoplasmosis or CMV)
malignancies

19

what can acute adrenal insufficiency occur after?

surgery
pregnancy
trauma
salt loss with excessive sweating

20

Addisonian crisis

acute adrenal insufficiency in a patient previously diagnosed with Addison's Disease

21

what is the primary cause of problems encountered by patients with Addisons

decreases in cortisol and aldosterone output

22

what does cortisol do

promotes gluconeogenesis (stimulates output of blood glucose)

23

what does a cortisol deficiency cause

-decrease in gluconeogenesis
-hypoglycemia
-deficiency of liver glycogen
-increased production of adrenocorticotropic horomone (ACTH)
-increased release of melanocyte stimulating hormone (causes darkening of skin pigmentation)

24

sx of cortisol deficiency

weakness
exhaustion
hypotension
anorexia, weight loss
nausea, vomiting
mild neuroses to profound depresssion
diminished resistance to stress

25

what does aldosterone do

causes retention of sodium and water
excretion of potassium

26

sx of aldosterone deficiency

hypotension
dehydration
craving for salt
elevated potassium
-most dangerous; can lead to arrhythmias

27

"other" sx of Addisons

decreased tolerance for even minor stress
poor coordination
decreased libido
amenorrhea (due to change in sex steroids)
poor tolerance for temp change

28

tx of Addison's Disease

synthetic corticosteroids and mineralocorticoids

29

side effects of synthetic corticosteroids and mineralocorticoids

more likely to develop osteoporosis, hypertension, and Type II diabetes

30

why is type II diabetes a side effect of hormone replacement therapy

cortisol decreases insulin sensitivity

31

what causes secondary adrenal insufficiency

hypothalamic or pituitary tumor
removal of pituitary or hypopituitarism
sudden withdrawal of corticosteroid drug therapy

32

what can happen with an Addisonian crisis

patient can quickly go into shock and die
need immediate hospitalization

33

how is secondary adrenal insufficiency different from primary

sx that occur are related to cortisol deficiency because the mineralocortocoids are not dependent upon pituitary control (if insufficiency is due to pituitary dysfunction)

34

does hyperpigmentation occur in secondary

no; ACTH output is low

35

tx of secondary adrenal insufficiency

hormone replacement therapy